TG and movement disorder: Patients may initially be referred to a pediatric neurologist, pediatric endocrinologist, or pediatric gastroenterologist, but over time, their symptoms become progressively severe and include cognitive issues, gross and fine motor delay, movement disorders such as hypokinesia and dystonia, mixed hypotonia with axial spasticity, limited ability to communicate, lack of weight gain, lack of increase in muscle tone, sleep problems, thyroid hormone abnormalities, and cardiac complications, alongside the presenting symptoms (1, 2, 4–6, 8, 13, 14, 17, 18).